Related Experiment Video
Updated: May 24, 2025
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Beating heart superior caval vein replacement for giant venous aneurysm: a case report
Kira Osipenko1, Daniel Zimpfer1, Maria Anwar2
1Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
Insights
Superior vena cava (SVC) aneurysms are rare. This case demonstrates successful surgical repair of a large SVC aneurysm using an expanded polytetrafluoroethylene (ePTFE) graft, offering a durable solution.
Area of Science:
- Vascular Surgery
- Cardiovascular Research
- Medical Case Reports
Background:
- Superior vena cava (SVC) aneurysms are exceptionally rare vascular anomalies, with fewer than 80 cases documented globally.
- Large SVC aneurysms pose significant risks, including potential rupture and thrombosis, often requiring surgical intervention.
Observation:
- A 68-year-old male patient presented with a growing SVC aneurysm and a history of paroxysmal atrial fibrillation.
- The patient underwent surgical treatment involving caval resection and reconstruction with a 20 mm expanded polytetrafluoroethylene (ePTFE) graft.
- Additional procedures included left atrial appendage exclusion and pulmonary vein isolation.
Findings:
- The surgical procedure was successful, with an uneventful recovery.
- Postoperative imaging at three months confirmed excellent graft patency.
- No signs of thrombosis or aneurysm recurrence were observed.
Implications:
- This case represents the first documented use of caval resection and ePTFE graft replacement for an adult SVC aneurysm.
- Complete excision of the affected vessel segment and prosthetic replacement offer a definitive treatment strategy.
- This approach minimizes the risk of recurrence for complex SVC aneurysms.
Background:
Superior vena cava (SVC) aneurysms are rare vascular anomalies, with <80 cases reported worldwide. Large aneurysms carry a risk of rupture and thrombosis, eventually necessitating surgical intervention.
Case Summary:
We present the case of a 68-year-old male with a progressively enlarging SVC aneurysm and a history of paroxysmal atrial fibrillation. The patient underwent successful caval resection and replacement with a 20 mm expanded polytetrafluoroethylene (ePTFE) graft, accompanied by left atrial appendage exclusion and pulmonary vein isolation. The recovery from surgery was uneventful, and postoperative imaging confirmed excellent graft patency with no signs of thrombosis or recurrence at the three-month follow-up.
Discussion:
This case highlights the successful management of a large SVC aneurysm through complete resection and prosthetic replacement with a 20 mm ePTFE graft, with the first documented use of this technique in an adult patient. Caval resection and graft replacement ensure complete excision of affected tissue, minimizing the risk of recurrence after surgery for complex SVC aneurysms.
Related Concept Videos
01:24Esophageal Varices-I: Introduction
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...